Prise en charge des hépatites fulminantes

Determining the cause of fulminant hepatitis is an important step in the management of acute liver failure, so that specific treatment can be initiated and any contraindication to liver transplantation can be eliminated. The etiology of fulminant hepatitis varies in different countries and at different times. A viral etiology (especially hepatitis B virus) is now less frequent and paracetamol-induced fulminant hepatic failure is more common. The main cause of mortality in fulminant liver failure is increased intracranial pressure related to brain oedema. Brain death is the leading cause of death, occurring either by brain herniation, brain ischemia, brain hypoxia or uncontrolled fitting. Orthotopic liver transplantation is the only effective treatment of fulminant hepatic failure. The decision to perform emergency liver transplantation is taken according to either Beaujean's/Paul Brousse's or King's College criteria.